What Is Menopause?

Menopause is technically one day of a woman’s life. The day she hits one full year without a period is the day she reaches menopause. After that, she is in post-menopause. However, “menopause,” as it is commonly referred to, is the natural process a woman’s body undergoes as her ovaries gradually produce less estrogen and eventually stop releasing eggs.

STAGE 1

Perimenopause

ESTROGEN PRODUCTION FLUCTUATES

The first stage of menopause can last anywhere from one to seven years. Most women begin seeing signs of perimenopause in their 40s, but it’s not uncommon for women to see signs of early menopause in their 30s as well.During perimenopause, estrogen production fluctuates and the first signs of menopause begin to appear. Your symptoms could include:

Hot flashes

Sleep disturbances

Mood swings

Vaginal dryness

STAGE 2

Menopause

12 CONSECUTIVE MONTHS WITHOUT A PERIOD

Once your body has gone a full 12 months without a period, you’ve reached menopause. During this time, your ovaries stop releasing eggs and your estrogen levels remain low, leading to a wide range of symptoms that could include:

Hot flashes

Sleep disturbances

Aches & pains

Weight gain

Mood swings

STAGE 3

Postmenopause

ESTROGEN PRODUCTION LEVELS OUT

During the years after menopause, most women see a reduction in their hot flashes, mood swings, and sleep disturbances.Signs of post-menopausal health risks can be tough to spot, but because the body’s estrogen levels remain low, there are several new health conditions women in post-menopause need to be aware of, including:

Increased risk of heart disease

Increased risk of osteoporosis

Common Menopause Symptoms

Learn More About What You May Be Experiencing

Hot Flashes & Night Sweats

Decreased estrogen production can make the brain think the body is hot. It then triggers it to cool off by dilating blood vessels and sweating

Muscle & Joint Pain

Loss of estrogen during menopause can increase inflammation in the body and cause muscle and joint aches

Weight Gain

Menopause and weight gain seem to go hand in hand for many. Decreased estrogen can cause weight gain around the abdomen, hips, and thighs

Mood Swings

Menopause can feel like an emotional roller coaster as your body’s hormone levels adjust. Irritability, anxiety, sadness, and fatigue are all common

How do I know if it’s menopause or pregnancy? Can I get pregnant at 50 years old? Or is it too late? These are just some of the questions women find themselves asking about fertility as they progress into the early years of menopause and their period is ‘late’ for the first time in years.

Much of what we often think are the first signs of menopause—hot flashes, mood swings, sleep disturbances, and vaginal dryness—are often actually perimenopause symptoms. Perimenopause is the span of time in which our ovaries gradually begin to make less estrogen leading up to the day that marks one full year after our last period (menopause).

Heart disease risk increases for everyone as they age, but for women, symptoms can become more evident after the onset of menopause. Not only does a woman’s risk for heart disease increase around the same age she enters natural menopause,1 but heart disease is also the leading cause of death for women in the United States causing 1 out every 5 deaths each year.2 In honor of National Wear Red Day supporting women’s heart health, here are a few important things to know about managing heart health during the menopause transition.
Estrogen’s important role in heart health
While a woman is young, estrogen actually protects her against heart disease.1 During menopause, however, some unseen changes begin to occur. Blood vessel walls begin to change which can lead to more plaque build-up, and blood clots. Additionally, fat found within the blood begins to change, which can affect the way it flows through blood vessels.1 Levels of fibrinogen increase (a substance that helps blood clot), which has been linked to strokes and heart disease.1
Estrogen affects nearly every tissue and organ in our bodies, including heart and blood vessels.1 This connection was so well known that hormone replacement therapy was once thought to actually protect women from against heart disease.1 We now know that HRT does not protect women from heart disease, but the logic behind that assumption was founded in respect for the nature of this powerful hormone.
Read more surprising facts about estrogen
While scientists are still learning about the many effects of estrogen on the body, here is some of what we know about estrogen’s role in our cardiovascular system:1
Increases HDL cholesterol (the good kind)1
Decreases LDL cholesterol (the bad kind)1
Relaxes, smooths, and dilates blood vessels so blood flow increases1
Soaks up free radicals, naturally occurring particles in the blood that can damage the arteries and other tissues1
All of these processes are naturally affected when estrogen begins to decline. LDL levels increase and HDL levels decrease, all of which can lead to fat and cholesterol build-up in the arteries (the signature contributors to strokes and heart attacks).1
There are likely even more ways in which estrogen affects the cardiovascular system that we don’t know about yet. New research leads to more information, but can also lead to more questions.1 While we may not have control over the answers that scientists have yet to uncover, we have the power to listen to our body’s signals and to be as proactive as possible when it comes to managing our heart disease risks. The first step in this is to know our symptoms.
Power begins with knowing your symptoms
Women often exhibit different heart attack symptoms than men do, which can lead to delayed treatment and even a higher death rate.3 Symptoms that require immediate medical attention include, but are not limited to:3
Chest pain
Pain in the jaw, arms, back, or neck
Extreme fatigue
Shortness of breath, nausea, and feeling lightheaded
Unusual sweating
Upper stomach pain
Underlying symptoms may have gone easily unnoticed or dismissed for other problems before, but menopause can exacerbate them. Pay attention to the way your body is changing, even if it’s subtle. Evaluate your risk factors to see if you may be experiencing more symptoms during menopause than meet the eye.
Check in on your risk factors
Age isn’t the only factor when it comes to increased heart disease risk. Younger women who’ve undergone early or surgical menopause also have an increased risk as well.1 Both of these conditions can increase risk when combined with other factors, such as:1
Diabetes and prediabetes3
Smoking
High blood pressure
Elevated LDL cholesterol
Obesity
Sedentary lifestyle
Unhealthy diet3
Family history of heart disease
If you meet any of these and you want to be proactive about protecting your heart as you age, check in with your doctor to start taking active steps to protect your heart.
Start with some steps to reduce your risk factors
No matter what your risk factors are, there is still a lot you can do now to take control of your future health. Studies show women with the lowest risk of heart disease are those who:1
Quit or avoid smoking1
Do aerobic exercise 3–5 times a week for 30–40 minutes each1
Keep a diet low in saturated fat (<7% daily amount) and in trans-fats, but high in Omega 3 fats found in fish and other seafood1
Follow a diet that’s high in fiber, whole grains, vegetables, legumes, fruits, fish and folate-rich foods1
Treat and control medical conditions such as diabetes, high cholesterol, and high blood pressure (all of which are known heart disease risk factors for heart disease)1
Regular exercise and good nutrition seem to be the most common tips when it comes to avoiding heart disease. Aerobic exercises can include activities like walking, cycling, swimming, or dancing.4 Good nutrition emphasizes fruits, veggies, whole grains, low-fat dairy products, poultry, fish, and nuts (but limits red meat plus most sugary foods and beverages).4 Surround yourself with loved ones who cheer you on and support you, and tackle any changes you make one day at a time.
Stay educated and in touch with your body
Your doctor should be able to do regular screenings to test your blood pressure, cholesterol, and weight which can all help to assess your risk.3 These consistent checkups are important even if you don’t have any symptoms. These updates can help us stay informed and ultimately decide for ourselves which steps to take when it comes to managing our lifestyle and habits. It all starts with education, and if you’ve made it to the end of this blog post you’re already well on your way toward that!
References
Cleveland Clinic. “Estrogen & Hormones.” 2019. Cleveland Clinic. Accessed on: January 28, 2020. <https://my.clevelandclinic.org/health/articles/16979-estrogen--hormones>
Center for Disease Control and Prevention. “Heart Disease: Women and Heart Disease.” 2019. U.S. Department of Health & Human Services. Accessed on: January 28, 2020. <https://www.cdc.gov/heartdisease/women.htm>
The North American Menopause Society. “Keeping Your Heart Healthy at Menopause.” 2020. Accessed on: January 28, 2020. <https://www.menopause.org/for-women/menopauseflashes/bone-health-and-heart-health/keeping-your-heart-healthy-at-menopause>
American Heart Association. “Menopause and Heart Disease.” 2015. Accessed on: January 28, 2020. <https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/menopause-and-heart-disease>

Thyroid problems and menopause share many of the same symptoms. They’re both common in middle age women, hard to identify, and can manifest in weight gain, fatigue, and mood swings. As we begin to view menopause as a holistic experience that affects our entire body, it’s important to take a look at what this little gland could mean for our overall health.

If you’ve been wondering when menopause really starts, how long it’s supposed to last, and whether or not you can get pregnant—we’ve got the answers for you. Watch as our Principal Nutrition Scientist, Dr. LeeCole Legette, addresses some of the most common misconceptions about menopause.

For generations, people have been calling menopause “the change.” Shouldn’t that be plural, though? So many things aren’t the same as they used to be, it’s tough to keep track of them all.
So, here’s a list of some of the most common things you can chalk up to your disappearing estrogen. It might not solve your problems. But at least you’ll know you’re not alone.
1. Hot flashes, flushes, night sweats, cold flashes, clammy skin
Add to that any other way you can think of to describe a sudden heat wave taking over your upper torso, neck and face from within. Caused by your confused blood vessels, which are getting overdilated due to hormone fluctuations. Could be helped tremendously by taking a plant-based* non-prescription supplement like Equelle. Explore other ways to beat the heat.
2. Brain fog
Having trouble recalling words or numbers? Forgetting things you did or why you did them? Good old estrogen used to work for you behind the scenes, helping you make all those neurological connections, and now you’re kind of understaffed.1 (See #1 above and #13 below.)
3. Heart racing, skipping beats or just general irregular rhythm
Hormone production is linked to your heartbeat, so as hormones shift during perimenopause, palpitations anywhere between a few seconds and a couple of minutes long are common. If yours differ or are accompanied by a rapid pulse and/or fainting, talk to your doctor.2
4. Insomnia or difficulty sleeping through the night
Night sweats don’t help anyone get a good night’s sleep. Neither do hormone-related shifts that mess with your circadian rhythms,3 and make you need to get up and go to the bathroom in the middle of the night.1 Anxiety can keep you up, too. And if you reach for your phone and start looking at social media when you can’t sleep, the blue light can keep you from getting back to sleep.4 How annoyingly ironic (see #5, below.)
5. Tiredness
Make that fatigue. Or maybe exhaustion is a better way to describe it. Can we attribute this to the night sweats? The insomnia? The irritation? All of the above? Probably. Is there more to it than that? Possibly. Is there anything we can do about it? Sure, if we can solve problem #4 above.1
6. Grumpiness
Many of us have been blaming hormones for our mood swings once a month since we first started getting our periods. But do you think maybe inadequate sleep and never knowing when you’re going to be drenched by a hot flash could have anything to do with it?
7. Unexpected tears
Sudden crying jags, often for no apparent reason are common among women with fluctuating hormones.5 (see #5 above and #7 below.)
8. Mental instability
You may feel a little sad, or totally unable to cope. There can also be a profound sense of loss involved with the change of life—as though you’ve lost yourself. The Harvard Study of Moods and Cycles recruited premenopausal women with no history of major depression and followed them for nine years. As some women entered perimenopause, they were twice as likely to have clinically significant depressive symptoms such as anxiety and panic attacks than those women who remained premenopausal.6,7
Hormone therapy is known to help dramatically, and doctors may prescribe other meds. Many of them would encourage you to also try quitting caffeine and alcohol.1
9. Unpredictable periods
Irregular cycles, shortened cycle, lengthened cycle, lighter flow than usual, heavier flow than usual, or a dramatic surprise appearance. Ah, the excitement and suspense of perimenopause.
10. Your sex drive stalls out
Or it downshifts. Or screeches to a halt. Some women even become repulsed by sex, the way they may have felt before the hormonal tidal wave of puberty first hit.1 Find ways to keep it fresh.
11. You need lube
Maybe you want to have sex, but your vagina doesn’t seem to be on board with the plan. It’s dry, dry, dry, and intercourse may be painful.4 There are tantalizing products on the market that can help, and they can be fun to shop for if you’re not suffering from symptom #10 above. (Handy household tip: coconut oil works, too.)
12. Oops, Bump, Ouch
Clumsiness, reduced reaction time, and/or trouble judging distances seem to be a menopause thing. (Read #13 below for more clues about this.)
13. Feeling disoriented or confused
Any combination of symptoms on this list could make a person feel this way. Still, this is good motivation for getting more mentally active and trying new things. Using your brain keeps it from atrophying. As brain researcher Marian Diamond says, “use it or lose it.”
14. Your balance is off
Aging can cause inner ear structures to break down, and hormonal changes associated with menopause can exacerbate the decline.8 Losing sleep also can affect your brain function and cause dizziness.9
15. Leakage
Ever hear the expression “I laughed so hard, I wet my pants”? We’re guessing it was a menopausal woman who came up with that. Loss of muscle tone and elasticity can cause incontinence, especially when you sneeze, laugh or lift something heavy.1 Maybe get serious about those Kegel exercises now. (Side note: strengthening your pelvic floor can have the added advantage of improving problem #10, above.)
16. You feel like something is crawling on you
Estrogen helps your skin produce oils and collagen. With less estrogen, skin loses moisture and plumpness.10 As it does, it can feel itchy or tickly, like there are bugs on you. Although it could just be the hair falling out onto your arms (see #20.)
17. You need a new bra wardrobe
Are the girls shape-shifting? As estrogen disappears, connective tissue in the breasts becomes dehydrated and loses elasticity. The breast tissue shrinks, loses shape and has trouble defying gravity. At the same time, if you’re gaining weight, your breasts are probably sizing up, and so is the circumference of your torso.11
18. Your head hurts
Migraines, tension headaches and cluster headaches can be associated with hormonal changes as well as the constricting and dilating of blood vessels that also causes hot flashes. Hormone replacement therapy can intensify headaches, too. There are meds that can help, and non-medical solutions like acupuncture, vitamin E, black cohosh, aerobic exercise, and yoga are worth trying.12
19. You’re gaining weight
Especially around the waist and thighs, filling in what used to be your waistline. As you lose muscle mass with age, your body burns calories more slowly. Sleep deprivation is also linked to weight gain.13 Move more. Eat less. Cut down on sugar and alcohol. Extra weight increases your risk of getting things you don’t want, like heart disease, type 2 diabetes, pulmonary problems and certain types of cancer.14
20. Your hair is different
The hair on your head is falling out, getting thin, going gray and changing texture. Your body hair is disappearing. At the same time, whiskers are appearing on your chin.15 Female Pattern Baldness is a thing, and it may have to do with menopause, it may be genetic, or it could be related to stress, thyroid disease or a medication you’re taking. Those chin hairs though? Hormones.16
21. Change stinks
Our body odor changes as we get older, and the hormonal changes you’re experiencing now may be responsible for that. Researchers have recently shown a relationship between our scent and our ability to reproduce.17
22. A shocking symptom
If you feel something like an electric shock under your skin or in your head, you’re not alone. It’s thought to be related to the body’s electrical system, which can get tripped up by the various physiological changes menopause brings.18
23. Prickly sensations
If your extremities feel numb sometimes, or you get that pins and needles thing, hormone imbalances can be the cause. But the tingling can also be a symptom of B12 deficiency, diabetes, changes in blood vessel flexibility, or a depletion of potassium or calcium,18 so if that persists, talk to your doctor.
24. Pink toothbrush
Gum problems all of a sudden? Researchers believe that bone loss and inflammation due to estrogen deficiency are the culprits here.19 Regular dental care and early diagnosis are the keys to keeping your teeth and gums as healthy as possible.
25. Burning Mouth Syndrome
This condition may be a reaction to the reduction in saliva some women experience as their estrogen levels get lower. It can cause a burning, tender, tingling, hot, scalding or numb sensation anywhere in the mouth, and there may be a metallic taste along with it.20
26. Cottonmouth
Estrogen loss causes dryness, and dryness in the mouth creates conditions for bacteria to thrive, and thriving bacteria means bad breath.21 Gum, anyone?
27. You’re shrinking
Osteoporosis shows up when estrogen cuts out, causing bone to break down faster than new bone can be built. Hormone therapy can help a lot, and drugs can reduce bone loss and stimulate new bone formation. If you haven’t lost bone density yet, cut your risk by getting 1000–1200 mg of calcium and 600–1000 IU of Vitamin D every day.1 Exercise regularly. If you still haven’t stopped smoking, stop smoking. And work on your balance so you can avoid falling down.
28. Your nails are in sad shape
Cracking, breaking, peeling, or soft nails? Estrogen is essential for producing keratin—the protein your nails are made of.22 Try stepping up your hand-and-cuticle moisturizing game and treat yourself to a gel manicure. Beautiful nails can be a great distraction from a sweaty face, extra weight, and any chin hairs your tweezers may have missed.
29. Your ears are ringing
Or whooshing, or buzzing, or making other sounds only you can hear. It’s called tinnitus, and it’s not clear if this annoying condition is menopause-related, or one of those age-related things that happen to pop up at the same time as menopause.8 It’s also a known side effect of medications a lot of us take for other symptoms on this list, including aspirin and Prozac. If you really can’t stand it, an audiologist can make you an over-the-ear white noise gadget called a tinnitus masker. If you think more noise will help.
30. Sore, aching muscles and joints
Turns out, inflammation is yet another thing estrogen was good at controlling. Muscle tension can also be caused by anxiety, or any of the other symptoms, above really. Relaxing with yoga, meditation or a nice massage can help. Equelle can also be helpful with this type of muscle discomfort.
*The active ingredient in Equelle is S-equol, a plant-based, naturally derived compound.
REFERENCES:1. Allmen, Tara. Menopause Confidential: a Doctor Reveals the Secrets to Thriving through Midlife. HarperOne, an Imprint of HarperCollins Publishers, 2016.2. Rosano G. M. et al. "Palpitations: What Is the Mechanism, and When Should We Treat Them?" Int J Fertil Womens Med. 1997; 42(2): 94-100.3. Deecher, D. C. et al. "Understanding the Pathophysiology of Vasomotor Symptoms (Hot Flushes and Night Sweats) That Occur in Perimenopause, Menopause, and Postmenopause Life Stages." Arch Womens Ment Health. 2007; 10(6): 247-57.4. Harvard Health Publishing. “Blue light has a dark side.” Harvard Health Letter. Accessed on: October 10, 2019. <https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side>5. UCLA Semel Institute for Neuroscience and Human Behavior.“Mood Disorders: Perimenopause & Menopause.” Accessed on: October 10, 2019. <https://www.semel.ucla.edu/mood/perimenopause-menopause>6. Cohen L. S., et al. "Risk for New Onset of Depression During the Menopausal Transition: The Harvard Study of Moods and Cycles." Arch Gen Psychiatry. 2006; 63(4): 385-90.7. Harlow B. L., et al. "Depression and Its Influence on Reproductive Endocrine and Menstrual Cycle Markers Associated with Perimenopause: The Harvard Study of Moods and Cycles." Arch Gen Psychiatry. 2003; 60(1): 29-36.8. Lai, J. T. et al. "Hormone Replacement Therapy for Chronic Tinnitus in Menopausal Women: Our Experience with 13 Cases." Clin Otolaryngo. 2017; 42(6): 1366-69.9. Masakazu T et al. “Dizziness in peri- and postmenopausal women is associated with anxiety: a cross-sectional study.” Journal of BioPsychoSocial Medicine. 2018; 12: 21.10. Nair, P. “Dermatosis associated with menopause.” Journal of Mid-Life Health. 2014; 5(4): 168–175.11. den Tonkelaar I et al. ”Increase in breast size after menopause: Prevalence and determinants.” Maturitas. 2003; 48(1):51-57.12. Lauritsen C. G. et al. “Current Treatment Options: Headache Related to Menopause-Diagnosis and Management.” Curr Treat Options Neurol. 2018; 20(4):7.13. Hruby, A et al. “Determinants and Consequences of Obesity”. American Journal of Public Health. 2016; 106(9): 1656–1662.14. Mishra G. et al. Health symptoms during midlife in relation to menopausal transition: British prospective cohort study. BMJ. 2012; 344: e402. Published online 2012 Feb 8. doi: 10.1136/bmj.e40215. Pierard-Franchimont C. et al. “Alterations in Hair Follicle Dynamics in Women.” Biomed Research Int. 2013; 957432.16. Blume-Peytavi, U et al. “Skin Academy: Hair, skin, hormones and menopause - current status/knowledge on the management of hair disorders in menopausal women” Eur J Dermatol. 2012; 22(3):310-18 17. Lobmaier J.S. et al. “The scent of attractiveness: levels of reproductive hormones explain the individual differences in women’s body odour.” Proc Bio Sci. 2018; 285(1886). 18. Association of Women for the Advancement of Research and Education - Project Aware. "The 35 Symptoms of Menopause." Accessed on: October 10, 2019. <https://www.project-aware.org/Experience/symptoms.shtml>19. Buencamino M. C. et al. “How menopause affects oral health, and what we can do about it.” Cleve Clin J Med. 2009;76(8):467-75.20. Dahiya P. et al. “Burning mouth syndrome and menopause.” Int J of Prev Med. 2013; 4(1):15-20.21. Mutneja P et al. “Menopause and the oral cavity.” Indian Journal of Endocrinol and Metab. 2012; 16(4): 548–551.22. Goluch-Koniuszy, ZS. “Nutrition of women with hair loss problem during the period of menopause.” Prz Menopauzalny (Menopause Review). 2016; 15(1): 56–61.

Ah, sex after menopause—the time in a women’s life that we all finally envision enjoyable intercourse without pain, bleeding, or a fear of getting pregnant. Right? Yes and No. While menopause can and should be one of the most sexually liberating periods in a woman’s life, it’s perfectly normal that it may take time to adjust for some. Vaginal dryness, thinning, and atrophy are just a few examples of how diminishing estrogen levels may present new challenges in the bedroom.

Sleep is precious during every stage of life, but especially during transitional periods such as menopause. It may not be surprising to know that women in their forties and fifties report more difficulty sleeping (insomnia) than younger women. A surprising 61% of women continue to report insomnia symptoms into their postmenopausal years.

Whether you’re just beginning to experience symptoms, or you’re ten years into postmenopause, doctors can be valuable allies for us during this time of transition. Each phase of menopause means different things for everyone and presents new questions.

You don’t have to be a woman to know that estrogen plays a seriously powerful role in a woman’s life. While the conversation around menopause tends to focus on very specific side effects, this hormone supports a range of vital organs and tissues. Embracing and educating ourselves about estrogen’s role in our overall health might unlock some life-changing truths about how to navigate our own menopause journey.

Like anything else that’s been going strong for a long time, menstruation doesn’t just screech to a sudden unexpected stop on a random day. Long before your last-ever period, your body starts prepping for its next phase—sometimes years in advance.
This pre-game is called perimenopause. That’s when the stash of eggs in your ovaries is running close to empty, causing your estrogen to begin its descent to the unfamiliar low point that menopause ultimately brings. If your periods have started to waver from their normal, you’re probably in peri territory.

September is Menopause Awareness month, but if you’re reading this you’re probably more than aware of it. Our experiences and emotional reactions will be as varied as we are. For some women, the menopause journey signals new beginnings. While for others, it can be an added burden during an already stressful time. Menopause Awareness month is a great opportunity to reflect on what this era means for our family, our friends, and for ourselves.

In this day of endless information and communication, it is puzzling that women are often unprepared for menopause -- the unpleasantness of the symptoms, the disruption to our lives, or the psychological impact of realizing we’re approaching “the change.”
The transition won’t be half as daunting if you have a good idea where you are on in your menopause transition, and what to expect as you move through the stages of menopause.
Knowing which stage of menopause you are in will help you not only understand and be better prepared for the physiological changes and symptoms you may experience, but even more important, will shine a light on the options that are available to you at each stage for symptom relief.
Okay, so what are the stages of menopause?
Menopause, as it is commonly referred to, is the natural process a woman’s body undergoes as her ovaries gradually produce less estrogen and eventually stop releasing eggs.
But menopause doesn’t happen all at once. It is a gradual transition that takes place over a period of years and happens in distinct stages. It starts with perimenopause as estrogen production begins to rise and fall unevenly and your periods become irregular. Once you’ve gone a full year without a menstrual cycle, you’ve officially hit menopause, which technically last only a single day, after which you are postmenopausal.
Let’s take a closer look at each stage in greater detail.
Stage 1: Perimenopause
Perimenopause is the stage leading up to menopause proper that can last anywhere from one to seven years. During perimenopause, estrogen production fluctuates and the first signs of menopause begin to appear. Your symptoms could include:
· Irregular menstrual cycles
· Hot flashes
· Mood swings
· Sleep disturbances
· Vaginal dryness
Most women begin seeing signs of perimenopause in their 40s, but it’s not uncommon for women to see signs of early menopause (premature menopause) in their 30s as well.
Many women have no idea perimenopause is even a thing until they’re in it. There are a couple of reasons for this. For one, perimenopause and menopause too often get lumped in together. But, even more so, we simply don’t talk enough about either stage. There is an alarming lack of conversation around menopause altogether, which leads to confusion. As a result, most of us just aren’t prepared when we enter perimenopause, so here’s everything you need to know.
The prefix “peri” means “around” or “near.” So, perimenopause pretty much means, “near menopause.” As the name implies, it’s the stage just before a woman enters menopause proper and stops having periods altogether.
But, the name is also a bit deceptive, because it’s actually during perimenopause that we start experiencing many (maybe all) of the symptoms classically associated with menopause.
This is because your body is in hormonal upheaval during perimenopause, and estrogen levels, in particular, fluctuate wildly.
Estrogen is one of the body’s great multitaskers, assisting with numerous important physiological functions. Your heart, bones, brain, bladder, vagina, and colon all have estrogen receptors and rely on this hard-working hormone to do their jobs effectively.
When your estrogen levels drop during perimenopause, it can disrupt many aspects of your health and well-being. These disruptions can appear as menopause symptoms, including hot flashes, night sweats, vaginal dryness, reduced libido, anxiety, mood swings, forgetfulness, brittle bones, muscles aches, and joint pains. Your body also may change in noticeable ways, such as thinning hair, weight gain (especially around the middle), and sagging skin.
How long does perimenopause last?
Perimenopause usually starts in our forties and can last anywhere from a few years to a decade, but for most women will last between four to eight years. However, some women start perimenopause much earlier, in their thirties.
How do you know if you’re perimenopausal?
The first sign of perimenopause is usually an irregular or unpredictable menstrual cycle. You may skip cycles, then, a few months later, get your period again. You may have two periods in a single month, have periods that last longer, have heavier or lighter flows, or constant spotting.
What’s the difference between perimenopause and menopause?
One big, big difference between perimenopause and menopause is that, during perimenopause, you are still menstruating, meaning you can still become pregnant. In fact, perimenopausal women are second only to teens in unexpected pregnancies, possibly because erratic cycles give women a mistaken belief that they aren’t fertile enough to conceive, so perimenopausal women have to remain vigilant about birth control.
The other major difference is that your body is still producing its own estrogen and progesterone. The problem is that it’s not producing these hormones as steadily or reliably as before, and levels can fluctuate wildly, making you feel like you’re riding a hormonal roller coaster.
What can I do to relieve my symptoms?
Because your body is still producing its own hormones during perimenopause, hormone replacement is not an option for dealing with symptoms during this stage, so you may want to explore diet and lifestyle interventions as well as nonprescription remedies such as supplements, and speak with your doctor about other prescription options such as low-dose birth control pills and antidepressants that have been shown to reduce hot flashes and other menopause symptoms.
Dealing with perimenopause symptoms
Diet and lifestyle interventions
Reduce stress as much as possible
Avoid alcohol, spicy foods, and caffeine
If you smoke, quit
Strive to maintain a healthy weight
Try controlled-breathing and self-calming exercises like yoga
Some women also find a measure of relief in eating estrogenic foods, including soy products such as soy nuts, edamame and tofu, as well as yams, flaxseeds and other plants that contain phytoestrogens. Estrogenic foods contain compounds like soy isoflavones. Daidzein, a soy isoflavone, is changed by gut bacteria into S-equol, a compound that is structurally similar to estrogen and mimics some (but not all) of its actions in the body, helping to reduce hot flash symptoms. (S-equol is not estrogen or a hormone.)
Nonprescription supplements
Since only about 20-30 percent of women in the U.S. can metabolize soy foods in a way that utilizes the S-equol, (and production depends on how much soy you actually intake in your diet) some women find taking an S-equol supplement helpful* to reduce hot flashes.
Prescription medications
Doctors will sometimes prescribe a form of low-dose birth control that evens out estrogen and progesterone levels to help perimenopausal women manage their symptoms
Another (non-hormonal) prescription option is antidepressants that have been shown to help alleviate a range of perimenopause symptoms, from the obvious (anxiety and mood swings) to the not-so-obvious (hot flashes and night sweats)
Stage 2: Menopause
Once your body has gone a full 12 months without a period, you’ve reached menopause. During this time, your ovaries stop releasing eggs and your estrogen levels remain low, leading to a wide range of symptoms that could include:
· Hot flashes
· Muscle aches & joint pains
· Mood swings
· Sleep disturbances
· Weight gain
Now we’ve arrived at the Big Show: menopause proper.
Strictly speaking, menopause means “the end of the period.” From a medical standpoint, a woman is considered to have reached menopause only when she has gone twelve months in a row without a period. So, menopause begins immediately after you’ve had your last menstrual cycle.
Most women enter natural menopause in their early fifties, though the transition can happen anywhere between the ages of forty and the late fifties. There are exceptions, of course. Some women will experience premature menopause, meaning they stop menstruating before the age of forty. And women who’ve had their ovaries removed surgically are said to have surgical menopause, because their bodies have stopped producing estrogen and progesterone.
Menopause technically lasts only one day ― the very first day after you haven’t had a period for one full year. Before that day, you are perimenopausal, and after you’re postmenopausal.
But, for the sake of simplicity, let’s look at this another way ― menopause is the period of time after you stop having periods but continue having symptoms such as hot flashes, sleep disturbances, aches and pains, vaginal dryness, and mood swings.
If the symptoms of perimenopause and menopause are basically the same, does it really matter which stage of menopause you’re in?
After all, a hot flash is a hot flash, right?
Actually, it matters very much. Menopause is physiologically very different from perimenopause. The major difference being that our bodies no longer make estrogen or progesterone. So, while your symptoms may be similar, your options for symptom relief are different.
Most importantly, once you reach menopause proper, you are eligible for hormone therapy, unless you have a personal or medical issue that makes taking hormones too risky, such as liver disease, blood-clotting disorder, a history of heart attack or breast cancer.
Stage 3: Post-menopause
There’s good news and bad news for postmenopausal women ― but mostly good news.
During the years after menopause, most women see a reduction in their hot flashes, mood swings, and sleep disturbances, along with general improvement in mood and mental clarity.
Post-menopause does, however, come with its own health challenges. Signs of postmenopausal health risks can be tough to spot, but because the body’s estrogen levels remain low, there are several new health conditions women in post-menopause need to be aware of, including:
· Increased risk of heart disease
· Increased risk of osteoporosis
Menopause is technically only one day of a woman’s life. The day she hits one full year without a period is the day she reaches menopause. After that, she is postmenopausal.
Once you stop having periods, and as long as you no longer have periods, you are postmenopausal. So, unless you spontaneously (and miraculously) begin menstruating again, you will be postmenopausal for the rest of your life (just to clarify, so you don’t have a panic attack about your periods returning: This scenario is medically impossible and has never happened).
You may continue to have some menopause symptom, but they should become less frequent, less intense, less disruptive to your life. Hormone levels will decline to a steady level, and your body will eventually reach a new hormonal balance.

Summer can be hot enough without hot flashes, and when you add them to the mix, it can feel downright sweltering. But with a few smart and stylish habit changes, you can find yourself cooler and just might discover a new favorite workout routine or wardrobe addition. Check out our five simple ways to stay cool during the hottest days of the year.
1. Slip Into Something Breathable
When it comes to summer fashion, you can stay looking hot, but dress cool. Free-flowing styles made from breathable fabrics are a good place to start. So, for summer staples like tanks, T-shirts, and sundresses, shop for cotton options.
However, if a cotton sundress is a little too casual for an event like a wedding or a summer night out, slip into a more refined linen dress, which is not only a cool option but classic one. Accessorize it with a belt of your choice for a breezy, beautiful look. Also, be sure to round out your wardrobe rotation with other pieces like chiffon broomstick skirts, balloon-sleeve blouses, and crochet tops for a look that’s both on trend and temperature-friendly.
2. Switch to Water Workouts
If the summer heat is making you feel sluggish and not motivated to work out and sweat even more than you already are, try switching up your workouts to incorporate some pool time. Not only will the cool water feel great, but swimming laps and other water workouts can provide both a cardio workout and resistance training that’s great for bone health.
3. Grab a Cool-Me-Down Pick-Me-Up
If you need a cup of hot coffee or tea to get going in the morning or pick you up in the afternoon, you could find that it not only peps you up but heats you up too. However, by switching to a glass of smooth and refreshing cold brew coffee or iced tea, you can keep your daily ritual and keep your cool.
It’s simple to make a week’s worth of either cold brew coffee or iced tea and keep it cold and ready in your fridge. And for an extra cool sip, try making ice cubes out of your brew. That way when the summer heat starts to melt your ice, your drink won’t get watered down. Just remember to keep an eye on your caffeine intake—cold brew coffee often contains more caffeine than regular coffee.
4. Make the Bed You Want to Lie
Just because the sun goes down doesn’t mean the heat does. For a cool, comfortable night of sleep, make your bed with breathable cotton sheets and for extra heat relief try a cooling gel mattress cover and pillow.
If you have a ceiling fan in your room, set it to rotate counter-clockwise to blow cool air down on you. And if you don’t have a ceiling fan, you can create a cooling crosswind by directing a fan to blow out of a room or window, with another fan across the room directing air toward the first fan.
5. Get to the Pulse Points
For a more direct way to cool down quickly, try cooling your body at your pulse points, where your blood vessels are closest to your skin. You’ll find them on your ankles, neck, elbows, and the backs of your knees.1 Apply a cool, damp cloth or a cold compress to one or more of these points, and you’ll be able to bring down your internal temperature more effectively.
Sources
1Nursecore. Keeping Cool This Summer. Version current 10 August 2012. Internet: http://www.nursecore.com/2012/08/keeping-cool-this-summer/ (accessed 12 December 2018).

Wondering what's "normal"? We're all different, and the symptoms we experience in menopause are too. While one woman might have mood swings and hot flashes, another might experience fatigue and weight gain. Here are some of the more and less common symptoms of menopause.

As women we do a lot and demand a ton from our bodies. So it’s no surprise we’re notoriously low in certain vitamins and minerals at various points in our lives. To help your body prepare for the changes that come with The Change, there are 6 nutrients you want to make sure you’re getting enough of during menopause.

Naturally alleviating hot flashes is a hot topic during menopause. But before you grab a handful of herbal supplements in the heat of the moment, consider the source and whether it is clinically shown to do what it claims.